Individual provider Active NPI

Donna Jean Destaso

  • Physician Assistant
  • Englewood Cliffs, NJ
National Provider Identifier
1194333534
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00579800 Issued in NJ
Practice address
910 Sylvan Ave Ste 100
Englewood Cliffs, NJ 07632-3308
Phone
(201) 569-2770
NPI assigned
Jul 22, 2020
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00579800 NJ Primary

Addresses

Primary practice location

910 Sylvan Ave Ste 100
Englewood Cliffs, NJ 07632-3308

Mailing address

302 Hopper CT
Franklin Lakes, NJ 07417-1143
Phone (201) 805-3763

Other practice location 1

4422 3rd Ave
Bronx, NY 10457-2545
Phone (201) 805-3763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201012000743 NY Practitioner - Physician Assistant 3173943289 Reassigns benefits to 1 organization
I20231212002516 NJ Practitioner - Physician Assistant 3173943289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 960-6205

4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6214

4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-6392

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC CurrentSince Sep 24, 2020 Accepting new patients
Gianna Scaglione PA-C LLC Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ddestaso18888@sbhny.direct-ci.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1194333534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HOPPER CT",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171143",
            "telephone_number": "201-805-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SYLVAN AVE STE 100",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323308",
            "telephone_number": "201-569-2770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104572545",
            "country_code": "US",
            "telephone_number": "201-805-3763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESTASO",
        "first_name": "DONNA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2023-12-26",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00579800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

Verify at the official NPI Registry.